Abstract
Reliable protein markers for pre-diabetes in humans are not clinically available. In order to identify novel and reliable protein markers for pre-diabetes in humans, healthy volunteers and patients diagnosed with pre-diabetes and stroke were recruited for blood collection. Blood samples were collected from healthy and pre-diabetic subjects 12 h after fasting. BMI was calculated from body weight and height. Fasting blood glucose (FBG), glycated hemoglobin (HbA1C), triglyceride (TG), total cholesterol, high-density lipoprotein, low-density lipoprotein (LDL), insulin and albumin were assayed by automated clinical laboratory methods. We used a quantitative proteomics approach to identify 1074 proteins from the sera of pre-diabetic and healthy subjects. Among them, 500 proteins were then selected using Mascot analysis scores. Further, 70 out of 500 proteins were selected via volcano plot analysis according to their statistical significance and average relative protein ratio. Eventually, 7 serum proteins were singled out as candidate markers for pre-diabetes due to their diabetic relevance and statistical significance. Immunoblotting data demonstrated that laminin subunit alpha 2 (LAMA2), mixed-lineage leukemia 4 (MLL4), and plexin domain containing 2 (PLXDC2) were expressed in pre-diabetic patients but not healthy volunteers. Receiver operating characteristic curve analysis indicated that the combination of the three proteins has greater diagnostic efficacy than any individual protein. Thus, LAMA2, MLL4 and PLXDC2 are novel and reliable serum protein markers for pre-diabetic diagnosis in humans.
Highlights
Diabetes is a metabolic disease characterized by hyperglycemia and defective carbohydrate metabolism resulting from insulin resistance/deficiency with b-cell dysfunction [1]
Fasting blood glucose (FBG), HbA1C, fasting insulin, and albumin were significantly different (p ≤ 0.05) between the healthy and pre-diabetic groups (Supplementary Table 1) [41]
We narrowed down the number of candidate markers by picking up proteins based on higher p values (< 0.01) and functions associated to diabetes, diabetic complications and obesity
Summary
Diabetes is a metabolic disease characterized by hyperglycemia and defective carbohydrate metabolism resulting from insulin resistance/deficiency with b-cell dysfunction [1]. In 2019, the International Diabetes Federation estimated that 9% of adults worldwide, 463 million people, lived with diabetes [2]. This disease caused 5 million deaths in the same year [2]. Genetic markers have high reliability, they are not satisfactory because they show up across the whole lifespan of patients with T2D, not at the onset of the disease or early in its progression, and sometimes have only modest sensitivity and specificity [13]. Protein markers have high sensitivity and specificity for T2D because they reflect the progression of the disease systemically and dynamically [13]. Protein markers are practical and have potential for diabetic diagnosis
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